JPH03170141A - Calculus crushing device - Google Patents

Abstract

PURPOSE:To use the bed as an operating table, and also, to facilitate the positioning of a crushing energy focus to a calculus by providing a calculus crushing energy generating device so as to be separable against a medical treatment bed, and constituting its moving base as specified. CONSTITUTION:On a medical treatment bed 1, a notch member 2 is provided, so that a shock wave generating device 3 goes therein. The shock wave generating device 3 is provided integrally with an ultrasonic tomography probe 4 held by a link mechanism 41, and placed on a moving base 5. When the shock wave generating device 3 is kept away from the bed 1 by moving the moving base 5 and a bed top board is fitted thereto and closed, the bed becomes useable as an operating table. In such a state, the shock wave generating device 3 is allowed to go into the notch part 2, and a calculus crushing medical treatment is executed. In this case, the shock wave generating device 3 is positioned under the belly of a patient lying on the bed 1. The moving base 5 being movable itself by wheels can allow the shock wave generating device 3 to ascend and descend vertically, and also, can move freely in the horizontal plane, and moreover, can rotate by using each of three orthogonal axes as the center axis.

Description

[Detailed description of the invention] [Industrial application field]

This invention involves generating acoustic (vibration) energy such as shock waves and ultrasonic waves outside the body, and concentrating it on the stone as energy for crushing the stone formed in the body, thereby crushing the stone. Regarding the equipment.

[Conventional technology]

In order to crush in-vivo stones using a stone crusher,
It is necessary to effectively focus the crushing energy on the stone. To this end, we use a stone detection device such as an ultrasound diagnostic device to accurately locate the stone and focus the crushing energy on that location. In order to perform this positioning accurately, conventionally, a treatment bed, a crushing energy generator such as an ultrasonic pulse generator, and a stone detection device are integrated into one unit. This is because it is possible to accurately and easily detect the stone position and position the focal point to that position using the bed as a reference. Also, a configuration is known in which only the crushing energy generator can be separated from the treatment bed and the calculus detector integrated therewith.

[Problem to be solved by the invention]

However, when a crushing energy generating device and a stone detecting device are integrated into a bed as in the past, there is a problem that the bed cannot be used independently as an operating table. Furthermore, if only the fragmentation energy generator can be separated from the bed, the bed can be used as an operating table, but the position of the fragmentation energy generator relative to the bed becomes ambiguous, and the focal point of the fragmentation energy is lost. Another problem arises in that it becomes difficult to accurately match the location of the stone. An object of the present invention is to provide a stone crushing device that allows a bed for performing stone crushing treatment to be used as an operating table, and also allows the focus of crushing energy to be easily aligned with the stone position.

[Means to solve the problem]

In order to achieve the above object, the stone crushing device according to the present invention includes a treatment bed having a cutout that can be opened and closed at will, and a crushing energy generating device that is large enough to fit into the cutout when it is opened. and a stone detection device integrally provided with the crushing energy generating device;
It is characterized in that it is equipped with a moving device that movably holds the crushing energy generating device and the calculus detecting device integrated therewith.

[For production]

A bed for lithotripsy treatment has a cutout that can be opened and closed at will. When this is closed, it becomes a normal bed without a cutout, so it can be used as a surgical table. When the cutout is opened, a cutout large enough to accommodate the crushing energy generating device is formed. The crushing energy generator has a stone detection device integrated therein, and is movably held by a moving device. Therefore, the notch can be opened and the crushing energy generator can be inserted into the notch. In this state, the patient is made to lie down on the bed and lithotripsy treatment is performed. At this time, the crushing energy generator is movable with respect to the bed, and its position cannot be precisely determined even with respect to the bed, but since it has an integrated device to detect the stone of the patient on the bed, it can be used to crush stones. It is possible to accurately determine the location of the stone relative to the energy generator, and based on this it is possible to focus the fragmentation energy precisely on the location of the stone.

【Example】

Next, an embodiment of the present invention will be described with reference to the drawings. In FIG. 1, a notch 2 is provided in the treatment bed (2). This notch 2 is provided at a position corresponding to the abdomen of a patient when lying on the bed 1, and a shock wave generator 3 is inserted into this notch 2. The shock wave generator 3 is
It has an integral ultrasonic tomographic probe 4 held by a link mechanism 41, and is mounted on a movable table 5. This movable table 5 is moved to move the shock wave generator 3 to the bed 1.
When moved away from the bed, a notch 2 remains, but this notch 2 can be closed by fitting a bed top plate (not shown), and when closed in this way, it looks like a normal treatment bed. Therefore, in this state, it can be used as an operating table. As shown in Fig. 1, the shock wave generator W
3 and perform stone crushing treatment. At this time, the shock wave generator W3 is positioned under the abdomen of the patient lying on the bed 1. This shock wave generator 3 is held by a moving table 5, and as shown in FIG. 2, this moving table 5 has a moving mechanism 51 with wheels and is movable by itself. Furthermore, the movable table 5 can move the shock wave generator 3 up and down, and can also move it freely in a horizontal plane (see the two-dot chain line in Fig. 2), as well as each of the three orthogonal axes. It can be rotated arbitrarily using the central axis. Therefore, the shock wave generator 3 can be moved arbitrarily and set at the most appropriate position and direction for the patient. The ultrasonic tomographic probe 4, which is integrally attached to the shock wave generator 3 via a link mechanism 41, is used to obtain a tomographic image of the patient's body, and is designed to inject an ultrasonic beam into the body and to emit a reflected ultrasonic beam. Receive waves. This received echo signal is sent to the main body of the ultrasonic diagnostic apparatus (not shown), and an ultrasonic tomographic image is displayed. Since the link mechanism 41 is provided with angle encoders 42 at various locations, information regarding the position of one lobe 4 can be obtained, and it is possible to know at which location the ultrasonic tomographic N image has been obtained. Therefore, if a stone image can be found in the ultrasonic tomographic image, the position of the stone relative to the shock wave generator W3 can be known, and the shock wave generator 3 is moved to the position closest to the stone accordingly. The water bag 31 provided above can be brought into close contact with the patient's body, and the shock wave generated from the shock wave generator 3 is adjusted so that the focus of the shock wave is precisely aligned with the stone position captured on the ultrasonic tomographic image. The focal position is electronically controlled to finely adjust the focal position. In this case, the focus position adjustment is performed by the shock wave generator 3 and the ultrasonic tomography probe 4 which is mechanically integrated with the shock wave generator 3 and whose position relative to the shock wave generator 3 can be accurately determined, making it easy to perform highly accurate positioning. It can be carried out. When the adjustment of the focal point position is completed, if the shock wave generator 3 is driven and the shock wave is made to enter the patient's body from below to above through the water bag 31, the shock wave will be accurately focused on the stone. Become. In this embodiment, the ultrasonic tomographic probe 4 is held by a link mechanism 41 outside the shock wave generator 3, but it is of course possible to incorporate it inside the shock wave generator 3. In this case, the ultrasonic beams transmitted and received from the ultrasonic tomographic probe 4 are transmitted to or received by the patient from below to above, similar to shock waves. Furthermore, although a shock wave generator is used as the stone crushing energy generator in the above description, it is possible to use an ultrasonic pulse generator or other acoustic (vibration) energy generator. Furthermore, stone detection devices other than ultrasonic diagnostic devices can also be used.

【Effect of the invention】

According to the stone crushing device of the present invention, since the stone crushing energy generating device can be separated from the treatment bed, this bed can be used as a surgical table. Moreover, even if the crushing energy generator can be separated from the bed in this way, it is easy to accurately position the crushing energy focus on the stone6.

[Brief explanation of the drawing]

FIG. 1 is a perspective view of one embodiment of the present invention, and FIG. 2 is a front view showing only the shock wave generator, ultrasonic tomography probe, and moving table shown in FIG. 1. l... Treatment bed, 2... Notch, 3... Shock wave generator, 31... Water bag, 4... Ultrasonic tomographic probe, 41... Link mechanism, 42... Angle encoder, 5... Moving table, 51... Moving mechanism.

Claims (1)

[Claims] (1) A treatment bed having a notch that can be opened and closed at will, a crushing energy generator of a size that can fit into the open notch, and a crushing energy generator that is integrally provided with the crushing energy generator. A stone crushing device comprising: a stone detecting device that has a stone crushing device; and a moving device that movably holds the crushing energy generating device and the stone detecting device integrated therewith.